Source: Palliative care outcomes tables (192KB XLS)
Palliative care outcome measures and benchmarks
In 2009, PCOC and participating services, developed and implemented a set of national outcome measures and associated benchmarks to drive service innovation and allow participating services to compare their service nationally. These outcome measures cover:
- time from date ready for care to episode start (Benchmark 1)
- time patient spent in an unstable phase (Benchmark 2)
- change in symptoms and problems (Benchmark 3).
In 2015, six additional measures relating to fatigue, breathing problems and family/carer problems were introduced. A full description of each of the PCOC benchmarks reported here is shown in Table PCOC.13. PCOC also reports on 8 casemix adjusted outcomes measures, not reported here.
Based on PCOC palliative care outcome benchmark results, in general, patients receiving inpatient care are more likely to achieve better outcomes than patients receiving community care (Figure PCOC.6). Research conducted by Eager, Clapham and Allingham (2018) found that over 85% of palliative care patients had no severe symptoms prior to death, and fewer hospital patients overall experienced severe distress from symptoms just prior to death than patients at home.
A high proportion of all patient episodes (92.6%) commenced within two days of the patient being ready (Benchmark 1) whilst 88.3% of patients spent 3 days or less in the unstable phase (Benchmark 2). Positive outcomes were achieved for 94.0% of patients beginning a phase with absent to mild breathing problems (Benchmark 3.7).
The majority of patients experienced no more than absent or mild symptoms or problems. For those patients who did experience moderate to severe distress from fatigue, 45.0% had this reduced to absent or mild (Benchmark 3.6). Similarly, moderate to severe distress from breathing problems was reduced to absent or mild for 47.9% of patients (Benchmark 3.8). Over half (56.0%) of patients who began experiencing moderate to severe distress from pain had this improved to absent/mild (Benchmark 3.4). Achieving an absent/mild symptom (or problem) outcome is less likely when the patient has moderate or severe symptoms (or problems) to begin with as is reflected in the outcome results.